Individual provider Active NPI

Jennica Lines, NP

  • Family Nurse Practitioner
  • Gilbert, AZ
National Provider Identifier
1730741208
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28861 Issued in AZ
Practice address
2487 S Gilbert Rd # 106-123
Gilbert, AZ 85295-8899
Phone
(480) 256-2696
NPI assigned
Jul 3, 2019
Last updated
Aug 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 56879 NM
Family Nurse Practitioner 363LF0000X 28861 AZ Primary
Registered Nurse 163W00000X RN-87926 NM
Registered Nurse 163W00000X RN176538 AZ

Addresses

Primary practice location

2487 S Gilbert Rd # 106-123
Gilbert, AZ 85295-8899

Mailing address

2487 S Gilbert Rd # 106-123
Gilbert, AZ 85295-8899
Phone (480) 256-2696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 1, 2026 through Apr 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN-87926NMMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1730741208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2487 S GILBERT RD # 106-123",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852958899",
            "telephone_number": "480-256-2696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2487 S GILBERT RD # 106-123",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852958899",
            "telephone_number": "480-256-2696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINES",
        "first_name": "JENNICA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-03",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "56879",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "28861",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "RN-87926",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN176538",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.